Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Interleukin (IL)-10 is expressed in many solid tumours and plays an ambiguous role in controlling cancer growth and metastasis. In order to determine whether IL-10 is involved in tumour progression and prognosis in nonsmall cell lung cancer (NSCLC), IL-10 expression in tumour cells and tumour-associated macrophages (TAMs) and its associations, if any, with clinicopathological features were investigated. Paraffin-embedded sections of surgical specimens obtained from 50 patients who had undergone surgery for NSCLC were immunostained with an antibody directed against IL-10. TAMs and tumour cells positive for IL-10 were subsequently quantified. IL-10-positive TAM percentage was higher in patients with stage II, III and IV NSCLC, and in those with lymph node metastases compared with patients with stage I NSCLC. High IL-10 expression by TAMs was a significant independent predictor of advanced tumour stage, and thus was associated with worse overall survival. Conversely, IL-10 expression by tumour cells did not differ between stages II, III and IV and stage I NSCLC. In conclusion, interleukin-10 expression by tumour-associated macrophages, but not by tumour cells, may play a role in the progression and prognosis of nonsmall cell lung cancer. These results may be useful in the development of novel approaches for anticancer treatments.
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PMID:Macrophage expression of interleukin-10 is a prognostic factor in nonsmall cell lung cancer. 1790 81

Segmentectomy demands a thorough knowledge of the three-dimensional bronchovascular anatomy of the lung. This anatomic detail makes segmentectomy significantly more challenging than lobectomy. Several principles must be applied when performing segmental lung resection: (1) the surgeon should avoid dissection in a poorly developed fissure, (2) use the transected bronchus as the base of the segmental resection during the division of the lung parenchymal in the intersegmental plane, (3) consider the use of endostapler division of the pulmonary parenchyma to reduce the air leak complications related to "finger fracture" dissection of the intersegmental plane, and (4) consider the use of adjuvant iodine 125 brachytherapy as a means of reducing local recurrence following sublobar resection. Increasing evidence supports the use of anatomic segmentectomy in the treatment of primary lung cancer for appropriately selected patients. This resection approach seems most appropriate in the management of the small (<2 cm in diameter) peripheral stage I NSCLC in which a generous margin of resection can be obtained. Accurate intraoperative nodal staging is important to estimate the relative use of these approaches compared with more aggressive resection and to determine the need for adjuvant systemic therapy if metastatic lymphadenopathy is identified. Future investigations comparing the results of sublobar resection with lobectomy will more clearly define the role of segmentectomy among good-risk patients with clinical stage I NSCLC. At the present time, it seems that sublobar resection is an appropriate therapy for the management of stage I NSCLC identified in the elderly patient, those individuals with significant cardiopulmonary dysfunction, and for the management of peripheral solitary metastatic disease to the lung. Because the primary disadvantage of sublobar resection is that of local recurrence, intraoperative adjuvant iodine 125 brachytherapy may be considered to minimize this local recurrence risk.
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PMID:Role of sublobar resection (segmentectomy and wedge resection) in the surgical management of non-small cell lung cancer. 1762 96

Several surgical, medical, irradiative, and image-guided focal ablative therapies are available for patients with primary non-small-cell lung cancer (NSCLC) or pulmonary metastases. The most appropriate therapy depends on cell type; the size, location, and number of tumors; the degree of local tumor spread and regional and distant metastases; the cardiopulmonary and functional status of the patient; symptoms; and therapeutic goals and desires of the patients and their caregivers. When potential cure or survival benefit is the goal, the most appropriate patients for radiofrequency (RF) ablation are those with stage I NSCLC or a few peripheral metastases limited to the lungs that are preferably less than 3 cm diameter, and who are not candidates for surgical resection. Because many of these patients will demonstrate local residual viable tumor or develop metastases or new primary tumors elsewhere, lifelong imaging surveillance with potential reintervention is warranted. When relief of tumor-related symptoms is the therapeutic goal, RF ablation may be applied to larger more advanced tumors with a reasonable expectation of improvement in a significant proportion of this population. In addition to judicious case selection, precise device placement with careful attention to RF ablation technique is essential to achieve optimized outcome with respect to complete tumor necrosis and avoidance of injury to critical nontargeted structures. Awareness of potential complications, use of techniques to minimize the probability of complications, and early recognition with aggressive management of complications are paramount to maintaining a satisfactory safety profile for RF ablation.
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PMID:Radiofrequency ablation of pulmonary malignancies. 1865 55

In previous years numerous advances in diagnostics, staging and therapy of lung cancer have been achieved. Nevertheless, it remains the most frequent cause of death from cancerous diseases. Early diagnosis and exact staging enable multimodal therapy regimens adjusted to age and comorbidities, which result in complete remission in a few and in prolonged survival and good quality of life in most patients. Curative surgery is possible in stage I non-small cell lung cancer (NSCLC) and results in a 5-year survival rates of up to approximately 75%. Using multimodal therapy approaches long-term survival can even be achieved in 40-50% of patients with advanced T4 tumors. However, in NSCLC with distant metastases median survival time is only 8-12 months. In elderly patients with no surgical options low cytotoxic monotherapy can be employed with a palliative intent. In the limited disease stage of small cell lung cancer (SCLC) long lasting remission after polychemotherapy has been observed in a minority of patients. However, in the extensive disease stage polychemotherapy prolongs the survival time of SCLC patients from 1-2 months to approximately 12 months.
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PMID:[Lung cancer from the perspective of internal medicine and surgery]. 2065 15

Metastasis-associated protein 1 (MTA1 protein) has been reported to be correlated with the biological behavior and prognosis of several malignant carcinomas. We hypothesized that stage I non-small cell lung cancer (NSCLC) patients with MTA1 protein overexpression would be more likely to have a poor prognosis. Therefore, we tested the expression of MTA1 protein in 60 stage I NSCLC and 30 paracarcinous normal lung tissues using the streptavidin-perosidase method. The Kaplan-Meier method was used to calculate the survival rate, and Cox regression analysis was performed to identify prognostic risk factors. MTA1 protein overexpression was detected in 22 stage I NSCLC tissues in this study. Tumor differentiation and tumor diameter were significantly associated with MTA1 protein overexpression, while not correlated with age, sex, pathological type or smoking status. The five-year survival rate of patients with MTA1 protein overexpression was significantly lower than that of those without expression (40.9% vs. 84.1%; P<0.001). The results of multivariate analysis confirmed that MTA1 protein overexpression was an independent prognostic factor (risk ratio=5.23, P=0.007). These findings demonstrated MTA1 might be a prognostic factor in NSCLC.
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PMID:Relation between prognosis and expression of metastasis-associated protein 1 in stage I non-small cell lung cancer. 2093 42

Only one third of patients with non-small-cell lung carcinoma (NSCLC) present with early-stage disease that is amenable to potentially curative resection and adjuvant therapy. Unfortunately, even in stage I NSCLC, 5-year survival rates are in the range of 55 to 72%. For unresectable disease in stages IIIB and IV, 5-year survival rates are < 5%. Postoperative chemotherapy (adjuvant chemotherapy) using cisplatin-based regimens has become the standard of care for resected stage II to IIIA NSCLC. However, adjuvant chemotherapy may be harmful in stage IA NSCLC, and its role for stage 1B is controversial. There are no conclusive data showing superiority of neoadjuvant chemotherapy (given prior to surgery) over adjuvant chemotherapy (given after surgery) or vice versa in early-stage NSCLC. Several emerging TARGETED therapy agents [e.g., inhibitors of vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), or tyrosine kinase], and combination chemotherapy regimens are currently being evaluated in NSCLC. Specific patient subpopulation characteristics (including EGFR mutations) may be prognostically important to identify potential responders (or nonresponders) to therapy. This review will focus on chemotherapeutic approaches to treat both early stage (adjuvant and neoadjuvant chemotherapy) and metastatic disease including the use of maintenance therapy and novel agents.
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PMID:Chemotherapy for non-small-cell lung carcinoma: from a blanket approach to individual therapy. 2150 Jan 27

Even when patients with nonsmall cell lung cancer undergo surgical resection at an early stage, recurrent disease often impairs the clinical outcome. There are numerous causes potentially responsible for a relapse of the disease, one of them being extensive angiogenesis. The balance of at least two systems, VEGF VEGFR and Ang Tie, regulates vessel formation. The aim of this study was to determine the impact of surgery on the plasma levels of the main angiogenic factors during the first month after surgery in nonsmall cell lung cancer patients. The study group consisted of 37 patients with stage I nonsmall cell lung cancer. Plasma concentrations of Ang1, Ang2, sTie2, VEGF, and sVEGF R1 were evaluated by ELISA three times: before surgical resection and on postoperative days 7 and 30. The median of Ang2 and VEGF concentrations increased on postoperative day 7 and decreased on day 30. On the other hand, the concentration of sTie2 decreased on the 7th day after resection and did not change statistically later on. The concentrations of Ang1 and sVEGF R1 did not change after the surgery. Lung cancer resection results in proangiogenic plasma protein changes that may stimulate tumor recurrences and metastases after early resection.
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PMID:Time-dependent changes of plasma concentrations of angiopoietins, vascular endothelial growth factor, and soluble forms of their receptors in nonsmall cell lung cancer patients following surgical resection. 2255 May 99

Metastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis. Clinical evidence suggests the existence of an intermediate, or oligometastatic, state when metastases are limited in number and/or location. In addition, following initial curative therapy, many patients present with limited metastatic disease, or oligo-recurrence. Metastasis-directed, anti-cancer therapies may benefit these patients. A growing evidence-base supports the use of hypofractionated, image-guided radiotherapy (HIGRT) for a variety of malignant conditions including inoperable stage I NSCLC and many metastatic sites. When surgical resection is not possible, HIGRT offers an effective alternative for local treatment of limited metastatic disease. Early studies have produced promising results when HIGRT was delivered to all known sites of disease in patients with oligometastatic/oligo-recurrent NSCLC. In a population of patients formerly considered rapidly terminal, these studies report five year overall survival rates of 13-22%. HIGRT for metastatic NSCLC warrants further study. We call for large, intergroup, and even international randomized trials incorporating HIGRT and other metastasis-directed therapies into the treatment of patients with oligometastatic/oligo-recurrent NSCLC.
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PMID:A call for the aggressive treatment of oligometastatic and oligo-recurrent non-small cell lung cancer. 2312 27

We have developed a new internal cooled electrode for radiofrequency ablation (RFA) (Japan Application no. 2006-88228) suitable for forceps channel bronchoscopy. Here, we present our clinical experience with bronchoscopy-guided RFA under computed tomography (CT) monitoring for patients with peripheral-type non-small-cell lung cancer (NSCLC). Bronchoscopy-guided RFA was performed in two patients (80 and 70 years old) with NSCLC, who had no lymph node involvement and distant metastases (T1N0M0), but not indicated for surgery because of other complications, such as advanced age, poor pulmonary function, and refusal of thoracic surgery. The locations of the tumors were right S2 and left S3, respectively. Although the tumors showed ground-glass opacity (GGO) with solid components in both cases, radiographic findings changed to reduced mass-like shadow and remained stable for 4 and 3.5 years after bronchoscopy-guided RFA. As the former case developed progressive disease on chest CT, bronchoscopy-guided RFA was repeated in the same lesion, resulting in no change for the subsequent 1 year. There were no adverse reactions during the procedures. Thus, bronchoscopy-guided RFA is a safe and feasible procedure that represents a potentially useful therapeutic tool in local control in medically inoperable patients with stage I NSCLC.
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PMID:Clinical experience of bronchoscopy-guided radiofrequency ablation for peripheral-type lung cancer. 2410 25

Limited data is available on salvage surgery for local relapse (LR) after stereotactic body radiotherapy (SBRT) for non-small cell lung cancer (NSCLC). We aimed to characterize treatment options and clarify long-term outcomes of isolated LR after SBRT for patients with clinical stage I NSCLC. Herein, we discuss technical aspects, perioperative management, and postoperative follow-up of two patients of the 12 patients undergoing salvage surgery for LR after SBRT at Kyoto University between 1999 and 2013. A 76-year-old male, 15 months after SBRT, underwent a salvage right upper lobectomy combined with adjacent right lower lobe wedge resection via video-assisted thoracoscopic surgery (VATS) for a 5.0-cm mass. Local recurrence was found 5 years after salvage surgery and treated with repeat SBRT, however he died from multiple distant metastases. An 85-year-old male, 14 months after SBRT, underwent a salvage left upper lobectomy via VATS for a 3.5-cm mass. Moderate intrapleural adhesion was noted and required careful dissection on the mediastinum. He is alive with no recurrence at 2 years from salvage surgery. Salvage VATS lobectomy was feasible after SBRT in two patients. Long-term follow-up and continued discussions at multidisciplinary conferences are required.
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PMID:Salvage video-assisted thoracoscopic lobectomy for isolated local relapse after stereotactic body radiotherapy for early stage non-small cell lung cancer: technical aspects and perioperative management. 2930 12


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